Individual provider Active NPI

Emmanuel Zapanta De Jesus, RPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1962798736
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030233-1 Issued in NY
Practice address
15 Bogota St
Staten Island, NY 10314
Phone
(661) 889-4906
Fax
(718) 351-3656
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 030233-1 NY Primary

Addresses

Primary practice location

15 Bogota St
Staten Island, NY 10314

Mailing address

15 Bogota St
Staten Island, NY 10314-6224
Phone (661) 889-4906

Other identifiers 1

IdentifierTypeStateIssuer
030233-1OtherNYLICENSE#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110630000063 NY Practitioner - Physical Therapist in Private Practice 0840478426 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ats Rehab OT and PT and SLP PLLCGroup PAC ID 2567734452, 39 clinicians
My Medical PCGroup PAC ID 0143610600, 93 clinicians
Peyman Younesi MD PLLCGroup PAC ID 4981860202, 98 clinicians

Practice addresses (Care Compare)

274 W Broadway
Long Beach, NY 11561-3911
Phone (718) 809-4370

70 Father Capodanno Blvd
Staten Island, NY 10305-4803
Phone (718) 709-0940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Dec 23, 2022 Accepting new patients
Peyman Younesi MD PLLC CurrentSince Nov 1, 2024 Accepting new patients
Rehabilitation Housecall PT & OT PLLC CurrentSince Nov 11, 2020 Accepting new patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
My Medical PC CurrentSince Jan 1, 2025 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Dec 19, 2019 Accepting new patients
Ats Rehab OT & PT & SLP PLLC Physical Therapist CurrentSince Oct 24, 2024 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Jun 8, 2022 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

3438 Bell Blvd
Ste 301
Bayside, NY 11361

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

2830 Pitkin Ave
Brooklyn, NY 11208
Phone (347) 420-8295

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

9131 175th St
Jamaica, NY 11432
Phone (340) 709-3133

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

70 Father Capodanno Blvd
Staten Island, NY 10305
Phone (718) 273-8900

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1962798736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BOGOTA ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146224",
            "telephone_number": "661-889-4906",
            "fax_number": "718-351-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BOGOTA ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "661-889-4906",
            "fax_number": "718-351-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "EMMANUEL",
        "middle_name": "ZAPANTA",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030233-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "030233-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.